Provider Demographics
NPI:1215032859
Name:SALTER, AMY LOGAN (OD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:LOGAN
Last Name:SALTER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 BUTTERNUT LN
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27520-5868
Mailing Address - Country:US
Mailing Address - Phone:919-359-2656
Mailing Address - Fax:
Practice Address - Street 1:100 BUTTERNUT LN
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27520-5868
Practice Address - Country:US
Practice Address - Phone:919-550-2464
Practice Address - Fax:919-550-3238
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2016-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1562152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1310160001OtherPALMETTO
NC890905QMedicaid
NC20399OtherOPTICARE
NC3151896003OtherCIGNA
NC2121520OtherMAMSI
NC0905QOtherBCBS
NC410047259OtherRAILROAD MEDICARE
NC562184637OtherSVS
NC5515693OtherAETNA
NC22-53787OtherUHC
NC24105OtherAVESIS
NC562184637OtherVSP
NCA7397OtherMEDCOST
NCU59861Medicare UPIN
NC0905QOtherBCBS